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. 2025 Jan 31;59(2):15-24.
doi: 10.47895/amp.vi0.8140. eCollection 2025.

The Effectiveness of Mindfulness-based Interventions versus Cognitive Behavioral Therapy on Social Anxiety of Adolescents: A Systematic Review and Meta-analysis

Valentin C Dones 3rd  1 , Kristel S Yamat  2 , Krystin Elda P Santos  2 , Abby Victoria M Concepcion  2 , Margarita Anne R Lacson  2
Affiliations

The Effectiveness of Mindfulness-based Interventions versus Cognitive Behavioral Therapy on Social Anxiety of Adolescents: A Systematic Review and Meta-analysis

Valentin C Dones 3rd et al. Acta Med Philipp. .

Abstract

Background and objective: Mindfulness-based interventions (MBI), a novel treatment, and cognitive behavioral therapy (CBT), the standard treatment, are both effective in treating anxiety in adolescents. This study determined the effectiveness of mindfulness-based interventions versus cognitive behavioral therapy in reducing symptoms of anxiety among adolescents experiencing social anxiety through a systematic review and meta-analysis.

Methods: A systematic approach was used to identify eligible studies. Electronic databases, reference lists of relevant articles, and gray literature were searched. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and subgroups. Heterogeneity was measured using visual assessment, the I2 statistic, and chi-square test.

Results: Randomized controlled trials comparing MBI to CBT for adolescents diagnosed with social anxiety or social phobia disorder were analyzed, with non-randomized studies being excluded. Structured searches in electronic databases, reference lists, and gray literature were conducted by four independent reviewers who initially identified potential articles through title and abstract screening. After a comprehensive review of full-text articles and a consensus-building process, the selection of included articles was finalized. Data was analyzed using RevMan to calculate standard mean differences with 95% confidence intervals and to examine subgroups, with heterogeneity being assessed through visual evaluation, the I2 statistic, and chi-square tests. Total number of participants was 255; 101 were male and 158 were women. Mean age was 27.5 years old, and diagnosed with Social Anxiety Disorder, Social Phobia, or DSM-IV-Defined-Anxiety-Disorder. They were divided into two groups: 125 participated in 8- to 12-week MBI sessions lasting 2 hours each, while 130 underwent 2-hour CBT sessions spanning 8, 12, or 14 weeks. There is moderate quality of evidence reporting non-significant difference on MBI vs CBT's effectiveness in alleviating symptoms of social anxiety [mean (95% CI) = -0.04 (-0.58, 0.51)].

Conclusion: Study found that there were no significant differences between Mindfulness-Based Interventions and Cognitive Behavioral Therapy in reducing social anxiety in adolescents. Mindfulness interventions have advantages in terms of cost-effectiveness for reducing symptoms of anxiety. Future research should include larger sample sizes and longer follow-up periods to further assess long-term effects of these interventions.

Keywords: adolescents; cognitive behavioral therapy; mindfulness; occupational therapy; social anxiety.

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Conflict of interest statement

All authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA study flow diagram.
Figure 2
Figure 2
Quality scoring of the included studies using the Cochrane Risk of Bias Tool.
Figure 3
Figure 3
Forest Plot.
See this image and copyright information in PMC

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